Joanne Goldblum saw poor people reusing disposable diapers and had to do something. Her nonprofit, The Diaper Bank, now gives 150,000 diapers a month to people in need.

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Joanne Goldblum remembers Jackie, a mentally retarded mother with two children, as the first person she’d ever seen dry and reuse a disposable diaper. Instead of toilet paper, Jackie kept a communal towel by the toilet. Goldblum still cringes when she tells the story. As a social worker for the Yale Child Study Center, Goldblum worked with families who were chronically homeless, families like Jackie’s. “They were living in a way you couldn’t believe was happening in America,” Goldblum says.

Goldblum set out to teach Jackie about the importance of cleanliness in keeping a family healthy. But Jackie insisted that she could not afford toilet paper. “Honestly, I thought she didn’t understand,” Goldblum says. So the social worker checked to see if Jackie could use Food Stamps to get toilet paper, only to find that the Food Stamps program pays for nothing except food. Then she turned to the federal Women, Infants and Children program, which provides supplemental nutrition to babies and pregnant women, and received the same answer: food only. Food pantries received donations of toiletries on occasion but never enough to meet the needs of all their clients.

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Jackie, it turns out, understood perfectly. No government program would help her buy the products she needed to keep her family clean. Living in New Haven, Conn., where the rent for a two-bedroom apartment approaches a minimum-wage worker’s monthly gross income, she could never spare the cash for diapers, toilet paper or soap. Jackie was not the only mother in Goldblum’s caseload with that problem. One apartment Goldblum visited was dotted with piles of garbage. There was no trash can because there was no money to buy it. Children wore foul-smelling clothes because there was no detergent to wash them with. And in family after family, disposable diapers were being reused. Mothers would dump out the solids and put the diapers back on the babies.

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Goldblum spent the next two years learning that the cost of cleanliness was quicksand, pulling already poor families down into intractable poverty. Parents who could not keep their homes or children clean would lose their children to the foster system. Day care centers require families to provide disposable diapers, and without day care, parents cannot work. Goldblum learned about the problem and railed about it. A lot of that railing happened at dinnertime. One night her husband, David, looked across the table and said, “Your diaper thing: We could just do it.”

Dinners changed quite a bit in the Goldblum house after that, as the dining room quickly filled with boxes of disposable diapers. The Goldblums and other volunteers would buy them at a local warehouse club and distribute monthly to social service agencies. Now, some four years later, her nonprofit organization, The Diaper Bank, gives away 150,000 diapers a month. The bank uses a warehouse, not a dining room, to store the diapers.

“It Can’t Be That Hard”
“There were people — a lot of people — who laughed at me,” Goldblum remembers, but her husband was encouraging.

“It can’t be that hard,” he insisted. She took that to heart.

“She just went right to it,” says Janice Ford Griffin of the Robert Wood Johnson Foundation. “Often people see an issue and think about the mechanics of doing it, ‘How can I design a model?’”

Ford Griffin directs RWJF’s Community Health Leaders, a recognition and development program for grassroots activists who display “courage, creativity and commitment” in making their communities healthier. Goldblum was selected as a leader in 2007. The winners often come up with solutions that wouldn’t surface in a formal, strategic think tank, Ford Griffin explains.

Goldblum puts it differently: “Everyone looks at the big picture, but no one’s looking at the teeny picture.”

She started small, with a board of directors Goldblum describes as hands-on, meaning they drove minivans full of diapers. With administrative costs at zero, donors knew that every cent would go toward diapers for needy children. (Today, The Diaper Bank has a small staff but keeps its administrative costs at 5 percent.) The Diaper Bank became a favorite organization of state Sen. Toni Harp, a New Haven legislator who later secured state funding to help it expand. Goldblum’s RWJF award came with a $105,000 check for The Diaper Bank.

Goldblum kept her structure simple by using existing social service agencies to distribute the diapers. Her initial plan was to target large organizations, like local hospitals. But few big organizations wanted to take on the additional work of distributing diapers, so she turned to grassroots agencies, which responded enthusiastically.

“Broke by Monday or Tuesday Morning”
The Diaper Bank is a boon to parents like Verta Stevenson-Douglas. On her street in New Haven’s Hill neighborhood, every few houses sport boarded-up or barred windows and signs warning, “No Loitering.” Inside the home that Stevenson-Douglas shares with her extended family, however, the atmosphere changes. Floors shine, windows glitter and walls are lined with artwork and framed Bible passages.

Last year, Stevenson-Douglas adopted two girls about to be removed from their birth mother’s care by the state. They are now 2 and 3 years old. “I didn’t want them to go into the system. I didn’t want them to be separated,” she explains. She receives $407 a month in state assistance for the girls and WIC vouchers and Food Stamps to use on their behalf. The only assistance she gets for herself and her 10-year-old son is Medicaid. She earns too much at Dunkin’ Donuts to qualify for any other help, she says. At least she did until her recent layoff when business slowed. Her boss says he will try to get her work at another of his restaurants.

She shares expenses and child care with her sister, who works at Wal-Mart, and a niece, who is a nurse. But even when she’s employed, finances are tight. Toward the end of the month, there are no eggs for the children. “I’m broke by Monday or Tuesday morning,” Stevenson-Douglas sighs.

There is no question that the girls would not get changed as frequently if it weren’t for the free diapers. “It’s a struggle to buy food,” she explains.

Less than three miles apart physically, Stevenson-Douglas’ neighborhood is a world away from Goldblum’s — East Rock, where gracious colonials house Yale professors. Goldblum has had people from this world tell her, “There aren’t homeless people in New Haven.” She shakes her head at that obliviousness and says she’s “embarrassed” when people make too much of her decision to quit a paying job to start The Diaper Bank. “I’m very lucky that I could do that,” she says.

Goldblum’s experience as a mother of three reinforces for her the need to support struggling families. “Everybody with children talks about how difficult it is,” she says. Then she launches into a series of questions. What if you’re an hourly wage employee who can’t come to the teacher conference? What if you don’t have a phone to call the school? What if your kid comes to school dirty because you can’t afford detergent? She says society provides the same answer to all these questions: “You’re a bad parent.”

Monday Morning Rash
“You don’t know what a blessing this is,” says Roberta Knotts of the Christian Training and Healing Center in New Haven. On a steamy afternoon, she sits with her husband, Pastor Bernis Knotts, behind a door with a silver sticker announcing “This Property Is Protected By Jesus Christ,” waiting for parents to pick up their monthly supply of diapers. To be a diaper distribution site, an agency must demonstrate that the majority of its clients are at or below the federal poverty level. There is no additional paperwork for the family.

To the Knottses, the lack of red tape matters. It makes undocumented residents comfortable asking for help. And not being able to afford a basic need, such as diapers, is embarrassing enough for families, they add. “No one is going to be judged or questioned,” Pastor Knotts says.

The Diaper Bank’s close connection to community-based agencies allows it to reach directly into neighborhoods in a way that few large social service organizations can. For example, Roberta Knotts talked about The Diaper Bank with her friend, Ramona Knox, at a beauty shop. Knox, who works at an area public school, deals every day with “young, single parents — struggling parents.” Now Knox delivers diapers directly to those families, who otherwise might never have heard about the resource.

“They’re able to change the babies more frequently,” she says. “Kids are crying when they’re wet. It keeps them from getting angry with the babies.”

Preventing child abuse was one of Goldblum’s goals in setting up The Diaper Bank; so was keeping children healthier. Infrequent changing leads to diaper rash and, in extreme cases, to serious infection.

“Head Start facilities are all concerned … about Monday morning rash,” says Lynn Hopson, executive director of LULAC Head Start in New Haven. Monday morning rash is exactly what it says it is — the diaper rash that blooms over the weekend when children are changed less frequently as extremely poor families try to conserve diapers.

When the Head Start program opened its doors, it used startup funding to buy diapers and wipes. As Hopson took over the reins, LULAC was running in the red, its original stockpile of diapers was gone and the organization was buying diapers out of its own budget. Hopson started requiring parents to provide disposables. On a federal site visit, the organization was chided for this. The criticism sprung from Head Start’s philosophy, which Hopson explains as, “You never ask a parent for anything. You’re serving the poorest of the poor.” It’s a maxim she agrees with but could not afford to observe, as the organization’s federal funding had been reduced year by year. The Diaper Bank became a savior, she says, and now Monday morning rash has been banished at the LULAC Head Start center.

“Use Newspaper”
The Diaper Bank does have detractors. Goldblum fields calls from people suggesting that the poor should just make do. “Why don’t they use newspaper?” one man actually demanded. Others insist that “these women” should not have children. The most frequent criticism is that disposable diapers are bad for the environment.

Her response to the criticism comes as a description of the lives of low-income families: Almost none own washing machines. Laundromats do not permit cloth diapers in their machines. Even if Laundromats were an option, Goldblum continues, it takes a lot of detergent to keep a child in cloth diapers. Do the critics know how much detergent costs and how few poor people can afford it?

So disposable diapers are the only real option for most poor families, but, because they are poor, Goldblum says, those families typically pay premium prices. Depending on size, diapers will cost from 22 to 24 cents each at a warehouse club, she says. At the supermarket, they are 30 to 35 cents. People lacking the cash to buy in quantity or the transportation to get to larger stores often buy diapers at neighborhood bodegas in packages of six or 12. The cost works out to 50 or 60 cents per diaper.

Across the country, food pantries report that cleaning items are in high demand. On the occasions when California’s Food Bank of Contra Costa and Solano is able to hand out soap, clients act as if they’ve been given “a bar of gold,” says executive director Larry Sly. “A person who isn’t clean and neat isn’t going to make the best impression on a job interview,” he says.

A quarter of the families who come to the emergency pantry at Catholic Parish Outreach in Raleigh, N.C., ask for cleaning products, executive director Terry Foley says. CPO gave out detergent until the cost became prohibitive. “We cut down on detergent so we wouldn’t have to cut down on food,” Foley explains. “All the policy stuff and advocacy is for food.” Foley recognizes feeding families is her main responsibility but cannot help being distressed that people do without tampons, toothpaste and so on. “It’s so degrading,” she says.

While direct service workers are quick to praise efforts like The Diaper Bank, “big picture” people often discount the “teeny picture” approach as a temporary solution. Goldblum says one foundation officer told her, “We don’t fund Band-Aids.”

Making a Case for Clean
The Diaper Bank operates in three Connecticut cities, and Goldblum believes it’s meeting only a portion of statewide demand. Ultimately, however, her goal is to build recognition that cleanliness is a basic need and that it does not end with diapers. “I started The Diaper Bank because I didn’t think people would be interested in a Tampon Bank,” she often quips. Indeed, Goldblum, recognizing that babies inspire sympathy, made a strategic decision to start with diapers.

To raise consciousness of cleanliness issues, Goldblum is collaborating with researchers. A student at the Yale School of Management studied teen mothers and found that when they could not afford diapers, the young women stopped attending school and work. Goldblum is working with a professor at the Yale School of Nursing to assess high school students’ personal care needs, especially around feminine hygiene.

Sharing those findings with policymakers is a priority. Harp, the state senator who was an early supporter of The Diaper Bank, introduced legislation that would have provided state subsidies for diapers for low-income families. The bill died, but Goldblum says its mere introduction was “astounding.” She’s since briefed congressional staffers on the issue.

Goldblum is gaining notice for her social entrepreneurship; among other media attention, she was an ABC News “Person of the Week” in July. “I feel like people should think about this stuff, and it’s sort of sad that what I’m doing stands out,” she says. She’s conscious in interviews that she should stay on message and focus on diapers. But she often catches herself expanding into the larger issue of meeting basic hygiene needs so people do not become trapped in poverty.

“This is a way of providing independence,” she insists. “It’s not a Band-Aid.